{"id":221,"date":"2024-03-01T02:31:43","date_gmt":"2024-03-01T02:31:43","guid":{"rendered":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/?post_type=part&#038;p=221"},"modified":"2024-03-22T13:24:29","modified_gmt":"2024-03-22T13:24:29","slug":"9-bolumhareketli-bolumlu-protezlerde-okluzal-iliskiler","status":"publish","type":"part","link":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/part\/9-bolumhareketli-bolumlu-protezlerde-okluzal-iliskiler\/","title":{"raw":"9. B\u00f6l\u00fcm<br \/><em>Hareketli B\u00f6l\u00fcml\u00fc Protezlerde Okluzal \u0130li\u015fkiler<\/em>","rendered":"9. B\u00f6l\u00fcm<br \/><em>Hareketli B\u00f6l\u00fcml\u00fc Protezlerde Okluzal \u0130li\u015fkiler<\/em>"},"content":{"raw":"Hareketli b\u00f6l\u00fcml\u00fc protez ve geriye kalan di\u015fler aras\u0131ndaki okluzal uyum, \u00e7evre dokular\u0131n sa\u011fl\u0131\u011f\u0131n\u0131n korunmas\u0131nda \u00f6nemli bir fakt\u00f6rd\u00fcr. HBP vakalar\u0131nda geriye kalan di\u015flerin say\u0131s\u0131 ve konumu okluzyonu belirler. Okluzyonun tipi klinik olarak mandibulan\u0131n ekzentrik hareketlerindeki temaslar\u0131 ile analiz edilir. Sentrik ve ekzentrik temaslarda HBP\u2019nin stabilitesi korunmal\u0131d\u0131r.\r\n\r\nHBP hastalar\u0131 i\u00e7in okluzyonun temininde a\u015fa\u011f\u0131daki hususlar \u00f6nem kazan\u0131r:\r\n<ul>\r\n \t<li>Okluzyonun analizi<\/li>\r\n \t<li>Okluzal d\u00fczensizliklerin giderilmesi<\/li>\r\n \t<li>Sentrik ili\u015fki kayd\u0131<\/li>\r\n<\/ul>\r\n<h2>Okluzyonun analizi<\/h2>\r\nT\u00fcm okluzyon tiplerinde esas olan sentrik okluzyon esnas\u0131nda t\u00fcberk\u00fcller aras\u0131nda maksimum temas\u0131n sa\u011flanmas\u0131d\u0131r. Lateral hareketler okluzyonun tipini belirler.\r\n\r\nHastan\u0131n lateral \u00e7ene hareketleri (sa\u011fa lateral ve sola lateral hareket) de\u011ferlendirilerek, bu hareketler esnas\u0131ndaki \u00e7al\u0131\u015fan ve \u00e7al\u0131\u015fmayan-dengeleyen taraftaki antagonist di\u015f temaslar\u0131na g\u00f6re mevcut okluzyon tespit edilir.\r\n\r\nAlt \u00e7enenin lateral hareketi esnas\u0131nda, \u00e7al\u0131\u015fan tarafta alt kanin di\u015finin insizal ucu \u00fcst kaninin palatinal y\u00fczeyi ile temas\u0131 koruyarak hareket eder ve lateral hareket tamamland\u0131\u011f\u0131nda, alt kanin di\u015finin insizal tepesi ile \u00fcst kaninin insizal ucu temas halinde ve di\u011fer antagonist di\u015flerde diskluzyon (temass\u0131zl\u0131k) olu\u015fursa, hastan\u0131n mevcut okluzyonu <strong>kanin koruyuculu okluzyon<\/strong> olarak tan\u0131mlan\u0131r (\u015eekil 9-1).\r\n\r\n[caption id=\"attachment_1005\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1.jpg\"><img class=\"size-medium wp-image-1005\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1-300x200.jpg\" alt=\"\u015eekil 9-1. Kanin koruyuculu okluzyonda, alt kanin di\u015finin insizal tepesi \u00fcst kanin di\u015finin palatinal e\u011fimi \u00fczerinde kayar. \u00c7al\u0131\u015fan taraftaki kanin d\u0131\u015f\u0131ndaki di\u015flerde diskluzyon olu\u015fur.\" width=\"300\" height=\"200\" \/><\/a> <strong>\u015eekil 9-1.<\/strong> Kanin koruyuculu okluzyonda, alt kanin di\u015finin insizal tepesi \u00fcst kanin di\u015finin palatinal e\u011fimi \u00fczerinde kayar. \u00c7al\u0131\u015fan taraftaki kanin d\u0131\u015f\u0131ndaki di\u015flerde diskluzyon olu\u015fur.[\/caption]\r\n\r\nLateral hareket esnas\u0131nda, ayn\u0131 tarafta kanin di\u015fi ile birlikte, premolar di\u015fler de temas halindeyse grup fonksiyonu okluzyonu bir veya iki molar di\u015f de dahil olmak \u00fczere posterior di\u015fler temas halinde ise tek tarafl\u0131 unilateral balansl\u0131 okluzyon olarak adland\u0131r\u0131l\u0131r (\u015eekil 9-2).\r\n\r\n[caption id=\"attachment_1006\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2.jpg\"><img class=\"size-medium wp-image-1006\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2-300x200.jpg\" alt=\"\u015eekil 9-2. Tek tarafl\u0131 balansl\u0131 okluzyonda \u00e7al\u0131\u015fan taraftaki neredeyse t\u00fcm di\u015flerde bukkal t\u00fcberk\u00fclleriyle temas vard\u0131r.\" width=\"300\" height=\"200\" \/><\/a> <strong>\u015eekil 9-2.<\/strong> Tek tarafl\u0131 balansl\u0131 okluzyonda \u00e7al\u0131\u015fan taraftaki neredeyse t\u00fcm di\u015flerde bukkal t\u00fcberk\u00fclleriyle temas vard\u0131r.[\/caption]\r\n\r\nKanin koruyuculu, grup fonksiyon veya tek tarafl\u0131 balansl\u0131 okluzyonda \u00e7al\u0131\u015fan taraf\u0131n kar\u015f\u0131s\u0131ndaki di\u015flerde diskluzyon mevcuttur. \u00d6r; sa\u011fa lateral hareket esnas\u0131nda sol taraftaki antagonist di\u015fler aras\u0131nda temas olmaz. Lateral harekette sadece lateral hareketin oldu\u011fu taraftaki antagonist di\u015fler temas eder. Protruziv harekette ise anterior di\u015fler aras\u0131nda antagonist temas olu\u015fur; posterior b\u00f6lgede diskluzyon mevcuttur.\r\n\r\nAntagonist di\u015f temaslar\u0131n\u0131n olmad\u0131\u011f\u0131 durumlarda, hastan\u0131n okluzyonu k\u0131smi di\u015fsizli\u011fin durumuna g\u00f6re a\u015fa\u011f\u0131da belirtilen kriterlere uygun olarak yeniden olu\u015fturulur. Bir di\u011fer okluzyon tipi olan \u00e7ift tarafl\u0131-bilateral balansl\u0131 okluzyon, \u00e7o\u011funlukla b\u00f6yle durumlarda ge\u00e7erli olur.\r\n\r\n<strong>\u00c7ift tarafl\u0131 balansl\u0131 okluzyonda,<\/strong> di\u011fer okluzyon tiplerinde oldu\u011fu gibi, sentrikte bilateral balans olu\u015fur (\u015eekil 9-3).\r\n\r\n[caption id=\"attachment_1007\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3.jpg\"><img class=\"size-medium wp-image-1007\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3-300x201.jpg\" alt=\"\u015eekil 9-3. \u00c7ift tarafl\u0131 balansl\u0131 okluzyonda sentrikte bilateral temas.\" width=\"300\" height=\"201\" \/><\/a> <strong>\u015eekil 9-3.<\/strong> \u00c7ift tarafl\u0131 balansl\u0131 okluzyonda sentrikte bilateral temas.[\/caption]\r\n\r\n\u00c7ift tarafl\u0131 balansl\u0131 okluzyonda, lateral harekette hem \u00e7al\u0131\u015fan, hem de dengeleyen tarafta antagonist di\u015fler aras\u0131nda temas mevcuttur. \u00d6r; sola do\u011fru olan lateral hareket esnas\u0131nda \u00e7al\u0131\u015fan taraf antagonist di\u015f temaslar\u0131 \u00f6zellikle posterior alanda bukkal t\u00fcberk\u00fclleriyle ger\u00e7ekle\u015firken (\u015eekil 9-4a), kar\u015f\u0131t taraftaki mandibular di\u015flerin bukkal t\u00fcberk\u00fclleri, maksiller di\u015flerin palatinal t\u00fcberk\u00fclleriyle kar\u015f\u0131l\u0131kl\u0131 temas halindedir; b\u00f6ylece hareketli protezin sa\u011f taraf\u0131n\u0131n dokudan uzakla\u015fmas\u0131na engel olunur (\u015eekil 9-4b).\r\n<table class=\"shaded\" style=\"border-collapse: collapse; width: 50%;\" border=\"0\"><caption>\u015eekil 9-4. \u00c7ift tarafl\u0131 balansl\u0131 okluzyonda sol lateral harekette; a) \u00c7al\u0131\u015fan taraf antagonist di\u015f temaslar\u0131 bukkal t\u00fcberk\u00fcllerle ger\u00e7ekle\u015fir. b) Hareketin olmad\u0131\u011f\u0131 taraftaki antagonist di\u015f temaslar\u0131 \u00fcst di\u015flerin palatinal alt di\u015flerin bukkal t\u00fcberk\u00fclleriyle olu\u015fur.<\/caption>\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 100%;\">\r\n\r\n[caption id=\"attachment_1008\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a.jpg\"><img class=\"size-medium wp-image-1008\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a-300x200.jpg\" alt=\"\u015eekil 9-4a. \u00c7al\u0131\u015fan taraf antagonist di\u015f temaslar\u0131 bukkal t\u00fcberk\u00fcllerle ger\u00e7ekle\u015fir.\" width=\"300\" height=\"200\" \/><\/a> \u015eekil 9-4a. \u00c7al\u0131\u015fan taraf antagonist di\u015f temaslar\u0131 bukkal t\u00fcberk\u00fcllerle ger\u00e7ekle\u015fir.[\/caption]<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 100%;\">\r\n\r\n[caption id=\"attachment_1009\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b.jpg\"><img class=\"size-medium wp-image-1009\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b-300x201.jpg\" alt=\"\u015eekil 9-4b. Hareketin olmad\u0131\u011f\u0131 taraftaki antagonist di\u015f temaslar\u0131 \u00fcst di\u015flerin palatinal alt di\u015flerin bukkal t\u00fcberk\u00fclleriyle olu\u015fur.\" width=\"300\" height=\"201\" \/><\/a> \u015eekil 9-4b. Hareketin olmad\u0131\u011f\u0131 taraftaki antagonist di\u015f temaslar\u0131 \u00fcst di\u015flerin palatinal alt di\u015flerin bukkal t\u00fcberk\u00fclleriyle olu\u015fur.[\/caption]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\nProtruziv harekette ise \u00f6n b\u00f6lgede keser di\u015fler ba\u015fa ba\u015f konumdayken, arka b\u00f6lgede her iki taraftaki ikinci molar antagonist di\u015fler aras\u0131nda temas sa\u011flanarak, \u201c3-nokta temas\u0131\u201c olu\u015fturulur; b\u00f6ylece hasta \u00f6n di\u015fleriyle \u0131s\u0131rma hareketini yaparken, protezin posterior kaidesinin dokudan uzakla\u015fmas\u0131 \u00f6nlenir (\u015eekil 9-5).\r\n\r\n[caption id=\"attachment_1012\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5.jpg\"><img class=\"size-medium wp-image-1012\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5-300x200.jpg\" alt=\"\u015eekil 9-5. \u00c7ift tarafl\u0131 balansl\u0131 okluzyonda protruziv harekette \u00f6nde keser b\u00f6lgede, arkada ise her iki taraftaki ikinci molar di\u015flerde antagonist temaslar olu\u015fturularak, 3-nokta temas\u0131 sa\u011flan\u0131r.\" width=\"300\" height=\"200\" \/><\/a> <strong>\u015eekil 9-5.<\/strong> \u00c7ift tarafl\u0131 balansl\u0131 okluzyonda protruziv harekette \u00f6nde keser b\u00f6lgede, arkada ise her iki taraftaki ikinci molar di\u015flerde antagonist temaslar olu\u015fturularak, 3-nokta temas\u0131 sa\u011flan\u0131r.[\/caption]\r\n\r\nAncak protruziv temas\u0131n tam olarak sa\u011flanabilmesi i\u00e7in overbite mesafesinin 1 mm\u2019yi ge\u00e7memesi gerekir. Bu durumda, g\u00fcl\u00fcmsemede \u00fcst anterior di\u015flerin insizal kenarlar\u0131 \u00fcst dudaktan g\u00f6r\u00fcnmeyebilir ve protruziv balans sa\u011flama \u00e7abas\u0131 esteti\u011fi tehlikeye d\u00fc\u015f\u00fcrebilir. Dolay\u0131s\u0131yla bu konuda mutlaka hastan\u0131n fikri al\u0131nmal\u0131, esteti\u011fe \u00f6nem veren hastada protruziv balans\u0131n olu\u015fturulmas\u0131n\u0131n zor olaca\u011f\u0131 bilinerek, \u0131s\u0131rma hareketinden ka\u00e7\u0131nmas\u0131 veya tam tersi, \u0131s\u0131rmaya \u00f6nem veren bir hastaya g\u00fclme esnas\u0131nda di\u015flerinin g\u00f6r\u00fcn\u00fcrl\u00fc\u011f\u00fcn\u00fcn azalaca\u011f\u0131 konusunda bilgi verilmelidir. Bu durumda hasta \u00f6n di\u015flerini koparma ama\u00e7l\u0131 kullanabilme veya estetik g\u00f6r\u00fcn\u00fcm aras\u0131nda tercih yapma durumunda kalacakt\u0131r.\r\n<h2>Okluzal d\u00fczensizliklerin giderilmesi<\/h2>\r\nOkluzal d\u00fczensizlikler protezin ba\u015far\u0131s\u0131n\u0131 olumsuz y\u00f6nde etkiler. K\u0131smi di\u015fsiz vakalarda, farkl\u0131 zamanlarda di\u015flerin kaybedilmesi veya uzun s\u00fcre di\u015fsiz kalma gibi nedenlerle, mevcut di\u015fler di\u015fsiz bo\u015fluklara do\u011fru devrilir, kayar veya uzarlar (\u015eekil 9-6).\r\n\r\n[caption id=\"attachment_1013\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6.jpg\"><img class=\"size-medium wp-image-1013\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6-300x200.jpg\" alt=\"\u015eekil 9-6. Uzun s\u00fcre di\u015fsiz kalan bir hastada do\u011fal di\u015flerdeki konum de\u011fi\u015fiklikleri, okluzal d\u00fczensizlikler olu\u015fturur.\" width=\"300\" height=\"200\" \/><\/a> <strong>\u015eekil 9-6.<\/strong> Uzun s\u00fcre di\u015fsiz kalan bir hastada do\u011fal di\u015flerdeki konum de\u011fi\u015fiklikleri, okluzal d\u00fczensizlikler olu\u015fturur.[\/caption]\r\n\r\n\u00c7ok ender durumlarda di\u015fler do\u011fru konumlar\u0131n\u0131 korurlar ki; bu durumda \u015fansl\u0131 oldu\u011fu i\u00e7in hastay\u0131 kutlamak gerekir. Uzama veya devrilme basit d\u00fczeyde ise mine seviyesinde m\u00f6lleme, daha ileri d\u00fczeyde ise kron restorasyonu yap\u0131labilir. Ancak \u00e7o\u011funlukla okluzal d\u00fczlem seviyesini d\u00fczenlemek i\u00e7in kron restorasyonundan \u00f6nce kanal tedavisi yap\u0131lmas\u0131 gerekebilir. Daha ileri boyuttaki problemlerde, \u00f6r; kar\u015f\u0131t krete temas edecek kadar uzam\u0131\u015f bir di\u015fin varl\u0131\u011f\u0131nda, periodontal deste\u011fi de azalaca\u011f\u0131ndan, di\u015fin \u00e7ekimi bile d\u00fc\u015f\u00fcn\u00fcl\u00fcr. Bu karar\u0131n, do\u011fru okluzal ili\u015fki elde edilmi\u015f te\u015fhis modellerinde verilmesi en do\u011fru yoldur.\r\n<h2>Sentrik ili\u015fki kayd\u0131<\/h2>\r\nSentrik ili\u015fki kayd\u0131nda kullan\u0131lacak y\u00f6ntemin belirlenmesinde di\u015fsizli\u011fin s\u0131n\u0131f\u0131 ve antagonist di\u015f temaslar\u0131 g\u00f6z \u00f6n\u00fcnde tutulur.\r\n\r\nYeterli antagonist di\u015f varl\u0131\u011f\u0131nda, di\u015f destekli vakalarda modeller kar\u015f\u0131l\u0131kl\u0131 getirilir.\r\n\r\nYeterli antagonist di\u015f olmad\u0131\u011f\u0131nda, interokluzal kay\u0131t materyali kullan\u0131larak modeller kar\u015f\u0131l\u0131kl\u0131 getirilir.\r\n\r\nKar\u015f\u0131t \u00e7enede tam protez varl\u0131\u011f\u0131nda, serbest sonlu veya antagonist di\u015f temaslar\u0131n\u0131n olmad\u0131\u011f\u0131 vakalarda ge\u00e7ici kaide pla\u011f\u0131 ve \u015fablon kullan\u0131l\u0131r.","rendered":"<p>Hareketli b\u00f6l\u00fcml\u00fc protez ve geriye kalan di\u015fler aras\u0131ndaki okluzal uyum, \u00e7evre dokular\u0131n sa\u011fl\u0131\u011f\u0131n\u0131n korunmas\u0131nda \u00f6nemli bir fakt\u00f6rd\u00fcr. HBP vakalar\u0131nda geriye kalan di\u015flerin say\u0131s\u0131 ve konumu okluzyonu belirler. Okluzyonun tipi klinik olarak mandibulan\u0131n ekzentrik hareketlerindeki temaslar\u0131 ile analiz edilir. Sentrik ve ekzentrik temaslarda HBP\u2019nin stabilitesi korunmal\u0131d\u0131r.<\/p>\n<p>HBP hastalar\u0131 i\u00e7in okluzyonun temininde a\u015fa\u011f\u0131daki hususlar \u00f6nem kazan\u0131r:<\/p>\n<ul>\n<li>Okluzyonun analizi<\/li>\n<li>Okluzal d\u00fczensizliklerin giderilmesi<\/li>\n<li>Sentrik ili\u015fki kayd\u0131<\/li>\n<\/ul>\n<h2>Okluzyonun analizi<\/h2>\n<p>T\u00fcm okluzyon tiplerinde esas olan sentrik okluzyon esnas\u0131nda t\u00fcberk\u00fcller aras\u0131nda maksimum temas\u0131n sa\u011flanmas\u0131d\u0131r. Lateral hareketler okluzyonun tipini belirler.<\/p>\n<p>Hastan\u0131n lateral \u00e7ene hareketleri (sa\u011fa lateral ve sola lateral hareket) de\u011ferlendirilerek, bu hareketler esnas\u0131ndaki \u00e7al\u0131\u015fan ve \u00e7al\u0131\u015fmayan-dengeleyen taraftaki antagonist di\u015f temaslar\u0131na g\u00f6re mevcut okluzyon tespit edilir.<\/p>\n<p>Alt \u00e7enenin lateral hareketi esnas\u0131nda, \u00e7al\u0131\u015fan tarafta alt kanin di\u015finin insizal ucu \u00fcst kaninin palatinal y\u00fczeyi ile temas\u0131 koruyarak hareket eder ve lateral hareket tamamland\u0131\u011f\u0131nda, alt kanin di\u015finin insizal tepesi ile \u00fcst kaninin insizal ucu temas halinde ve di\u011fer antagonist di\u015flerde diskluzyon (temass\u0131zl\u0131k) olu\u015fursa, hastan\u0131n mevcut okluzyonu <strong>kanin koruyuculu okluzyon<\/strong> olarak tan\u0131mlan\u0131r (\u015eekil 9-1).<\/p>\n<figure id=\"attachment_1005\" aria-describedby=\"caption-attachment-1005\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1005\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1-300x200.jpg\" alt=\"\u015eekil 9-1. Kanin koruyuculu okluzyonda, alt kanin di\u015finin insizal tepesi \u00fcst kanin di\u015finin palatinal e\u011fimi \u00fczerinde kayar. \u00c7al\u0131\u015fan taraftaki kanin d\u0131\u015f\u0131ndaki di\u015flerde diskluzyon olu\u015fur.\" width=\"300\" height=\"200\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1-300x200.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1-1024x683.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1-768x512.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1-1536x1024.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1-65x43.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1-225x150.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1-350x233.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-1.jpg 1648w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1005\" class=\"wp-caption-text\"><strong>\u015eekil 9-1.<\/strong> Kanin koruyuculu okluzyonda, alt kanin di\u015finin insizal tepesi \u00fcst kanin di\u015finin palatinal e\u011fimi \u00fczerinde kayar. \u00c7al\u0131\u015fan taraftaki kanin d\u0131\u015f\u0131ndaki di\u015flerde diskluzyon olu\u015fur.<\/figcaption><\/figure>\n<p>Lateral hareket esnas\u0131nda, ayn\u0131 tarafta kanin di\u015fi ile birlikte, premolar di\u015fler de temas halindeyse grup fonksiyonu okluzyonu bir veya iki molar di\u015f de dahil olmak \u00fczere posterior di\u015fler temas halinde ise tek tarafl\u0131 unilateral balansl\u0131 okluzyon olarak adland\u0131r\u0131l\u0131r (\u015eekil 9-2).<\/p>\n<figure id=\"attachment_1006\" aria-describedby=\"caption-attachment-1006\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1006\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2-300x200.jpg\" alt=\"\u015eekil 9-2. Tek tarafl\u0131 balansl\u0131 okluzyonda \u00e7al\u0131\u015fan taraftaki neredeyse t\u00fcm di\u015flerde bukkal t\u00fcberk\u00fclleriyle temas vard\u0131r.\" width=\"300\" height=\"200\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2-300x200.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2-1024x684.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2-768x513.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2-1536x1026.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2-65x43.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2-225x150.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2-350x234.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-2.jpg 1649w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1006\" class=\"wp-caption-text\"><strong>\u015eekil 9-2.<\/strong> Tek tarafl\u0131 balansl\u0131 okluzyonda \u00e7al\u0131\u015fan taraftaki neredeyse t\u00fcm di\u015flerde bukkal t\u00fcberk\u00fclleriyle temas vard\u0131r.<\/figcaption><\/figure>\n<p>Kanin koruyuculu, grup fonksiyon veya tek tarafl\u0131 balansl\u0131 okluzyonda \u00e7al\u0131\u015fan taraf\u0131n kar\u015f\u0131s\u0131ndaki di\u015flerde diskluzyon mevcuttur. \u00d6r; sa\u011fa lateral hareket esnas\u0131nda sol taraftaki antagonist di\u015fler aras\u0131nda temas olmaz. Lateral harekette sadece lateral hareketin oldu\u011fu taraftaki antagonist di\u015fler temas eder. Protruziv harekette ise anterior di\u015fler aras\u0131nda antagonist temas olu\u015fur; posterior b\u00f6lgede diskluzyon mevcuttur.<\/p>\n<p>Antagonist di\u015f temaslar\u0131n\u0131n olmad\u0131\u011f\u0131 durumlarda, hastan\u0131n okluzyonu k\u0131smi di\u015fsizli\u011fin durumuna g\u00f6re a\u015fa\u011f\u0131da belirtilen kriterlere uygun olarak yeniden olu\u015fturulur. Bir di\u011fer okluzyon tipi olan \u00e7ift tarafl\u0131-bilateral balansl\u0131 okluzyon, \u00e7o\u011funlukla b\u00f6yle durumlarda ge\u00e7erli olur.<\/p>\n<p><strong>\u00c7ift tarafl\u0131 balansl\u0131 okluzyonda,<\/strong> di\u011fer okluzyon tiplerinde oldu\u011fu gibi, sentrikte bilateral balans olu\u015fur (\u015eekil 9-3).<\/p>\n<figure id=\"attachment_1007\" aria-describedby=\"caption-attachment-1007\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1007\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3-300x201.jpg\" alt=\"\u015eekil 9-3. \u00c7ift tarafl\u0131 balansl\u0131 okluzyonda sentrikte bilateral temas.\" width=\"300\" height=\"201\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3-300x201.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3-1024x685.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3-768x514.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3-1536x1027.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3-65x43.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3-225x150.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3-350x234.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-3.jpg 1654w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1007\" class=\"wp-caption-text\"><strong>\u015eekil 9-3.<\/strong> \u00c7ift tarafl\u0131 balansl\u0131 okluzyonda sentrikte bilateral temas.<\/figcaption><\/figure>\n<p>\u00c7ift tarafl\u0131 balansl\u0131 okluzyonda, lateral harekette hem \u00e7al\u0131\u015fan, hem de dengeleyen tarafta antagonist di\u015fler aras\u0131nda temas mevcuttur. \u00d6r; sola do\u011fru olan lateral hareket esnas\u0131nda \u00e7al\u0131\u015fan taraf antagonist di\u015f temaslar\u0131 \u00f6zellikle posterior alanda bukkal t\u00fcberk\u00fclleriyle ger\u00e7ekle\u015firken (\u015eekil 9-4a), kar\u015f\u0131t taraftaki mandibular di\u015flerin bukkal t\u00fcberk\u00fclleri, maksiller di\u015flerin palatinal t\u00fcberk\u00fclleriyle kar\u015f\u0131l\u0131kl\u0131 temas halindedir; b\u00f6ylece hareketli protezin sa\u011f taraf\u0131n\u0131n dokudan uzakla\u015fmas\u0131na engel olunur (\u015eekil 9-4b).<\/p>\n<table class=\"shaded\" style=\"border-collapse: collapse; width: 50%;\">\n<caption>\u015eekil 9-4. \u00c7ift tarafl\u0131 balansl\u0131 okluzyonda sol lateral harekette; a) \u00c7al\u0131\u015fan taraf antagonist di\u015f temaslar\u0131 bukkal t\u00fcberk\u00fcllerle ger\u00e7ekle\u015fir. b) Hareketin olmad\u0131\u011f\u0131 taraftaki antagonist di\u015f temaslar\u0131 \u00fcst di\u015flerin palatinal alt di\u015flerin bukkal t\u00fcberk\u00fclleriyle olu\u015fur.<\/caption>\n<tbody>\n<tr>\n<td style=\"width: 100%;\">\n<figure id=\"attachment_1008\" aria-describedby=\"caption-attachment-1008\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1008\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a-300x200.jpg\" alt=\"\u015eekil 9-4a. \u00c7al\u0131\u015fan taraf antagonist di\u015f temaslar\u0131 bukkal t\u00fcberk\u00fcllerle ger\u00e7ekle\u015fir.\" width=\"300\" height=\"200\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a-300x200.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a-1024x683.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a-768x513.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a-1536x1025.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a-65x43.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a-225x150.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a-350x234.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4a.jpg 1654w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1008\" class=\"wp-caption-text\">\u015eekil 9-4a. \u00c7al\u0131\u015fan taraf antagonist di\u015f temaslar\u0131 bukkal t\u00fcberk\u00fcllerle ger\u00e7ekle\u015fir.<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 100%;\">\n<figure id=\"attachment_1009\" aria-describedby=\"caption-attachment-1009\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1009\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b-300x201.jpg\" alt=\"\u015eekil 9-4b. Hareketin olmad\u0131\u011f\u0131 taraftaki antagonist di\u015f temaslar\u0131 \u00fcst di\u015flerin palatinal alt di\u015flerin bukkal t\u00fcberk\u00fclleriyle olu\u015fur.\" width=\"300\" height=\"201\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b-300x201.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b-1024x687.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b-768x515.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b-1536x1030.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b-65x44.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b-225x151.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b-350x235.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-4b.jpg 1654w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1009\" class=\"wp-caption-text\">\u015eekil 9-4b. Hareketin olmad\u0131\u011f\u0131 taraftaki antagonist di\u015f temaslar\u0131 \u00fcst di\u015flerin palatinal alt di\u015flerin bukkal t\u00fcberk\u00fclleriyle olu\u015fur.<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Protruziv harekette ise \u00f6n b\u00f6lgede keser di\u015fler ba\u015fa ba\u015f konumdayken, arka b\u00f6lgede her iki taraftaki ikinci molar antagonist di\u015fler aras\u0131nda temas sa\u011flanarak, \u201c3-nokta temas\u0131\u201c olu\u015fturulur; b\u00f6ylece hasta \u00f6n di\u015fleriyle \u0131s\u0131rma hareketini yaparken, protezin posterior kaidesinin dokudan uzakla\u015fmas\u0131 \u00f6nlenir (\u015eekil 9-5).<\/p>\n<figure id=\"attachment_1012\" aria-describedby=\"caption-attachment-1012\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1012\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5-300x200.jpg\" alt=\"\u015eekil 9-5. \u00c7ift tarafl\u0131 balansl\u0131 okluzyonda protruziv harekette \u00f6nde keser b\u00f6lgede, arkada ise her iki taraftaki ikinci molar di\u015flerde antagonist temaslar olu\u015fturularak, 3-nokta temas\u0131 sa\u011flan\u0131r.\" width=\"300\" height=\"200\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5-300x200.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5-1024x683.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5-768x512.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5-1536x1024.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5-65x43.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5-225x150.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5-350x233.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-5.jpg 1654w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1012\" class=\"wp-caption-text\"><strong>\u015eekil 9-5.<\/strong> \u00c7ift tarafl\u0131 balansl\u0131 okluzyonda protruziv harekette \u00f6nde keser b\u00f6lgede, arkada ise her iki taraftaki ikinci molar di\u015flerde antagonist temaslar olu\u015fturularak, 3-nokta temas\u0131 sa\u011flan\u0131r.<\/figcaption><\/figure>\n<p>Ancak protruziv temas\u0131n tam olarak sa\u011flanabilmesi i\u00e7in overbite mesafesinin 1 mm\u2019yi ge\u00e7memesi gerekir. Bu durumda, g\u00fcl\u00fcmsemede \u00fcst anterior di\u015flerin insizal kenarlar\u0131 \u00fcst dudaktan g\u00f6r\u00fcnmeyebilir ve protruziv balans sa\u011flama \u00e7abas\u0131 esteti\u011fi tehlikeye d\u00fc\u015f\u00fcrebilir. Dolay\u0131s\u0131yla bu konuda mutlaka hastan\u0131n fikri al\u0131nmal\u0131, esteti\u011fe \u00f6nem veren hastada protruziv balans\u0131n olu\u015fturulmas\u0131n\u0131n zor olaca\u011f\u0131 bilinerek, \u0131s\u0131rma hareketinden ka\u00e7\u0131nmas\u0131 veya tam tersi, \u0131s\u0131rmaya \u00f6nem veren bir hastaya g\u00fclme esnas\u0131nda di\u015flerinin g\u00f6r\u00fcn\u00fcrl\u00fc\u011f\u00fcn\u00fcn azalaca\u011f\u0131 konusunda bilgi verilmelidir. Bu durumda hasta \u00f6n di\u015flerini koparma ama\u00e7l\u0131 kullanabilme veya estetik g\u00f6r\u00fcn\u00fcm aras\u0131nda tercih yapma durumunda kalacakt\u0131r.<\/p>\n<h2>Okluzal d\u00fczensizliklerin giderilmesi<\/h2>\n<p>Okluzal d\u00fczensizlikler protezin ba\u015far\u0131s\u0131n\u0131 olumsuz y\u00f6nde etkiler. K\u0131smi di\u015fsiz vakalarda, farkl\u0131 zamanlarda di\u015flerin kaybedilmesi veya uzun s\u00fcre di\u015fsiz kalma gibi nedenlerle, mevcut di\u015fler di\u015fsiz bo\u015fluklara do\u011fru devrilir, kayar veya uzarlar (\u015eekil 9-6).<\/p>\n<figure id=\"attachment_1013\" aria-describedby=\"caption-attachment-1013\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1013\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6-300x200.jpg\" alt=\"\u015eekil 9-6. Uzun s\u00fcre di\u015fsiz kalan bir hastada do\u011fal di\u015flerdeki konum de\u011fi\u015fiklikleri, okluzal d\u00fczensizlikler olu\u015fturur.\" width=\"300\" height=\"200\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6-300x200.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6-1024x683.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6-768x513.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6-1536x1025.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6-65x43.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6-225x150.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6-350x234.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/9-6.jpg 1651w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1013\" class=\"wp-caption-text\"><strong>\u015eekil 9-6.<\/strong> Uzun s\u00fcre di\u015fsiz kalan bir hastada do\u011fal di\u015flerdeki konum de\u011fi\u015fiklikleri, okluzal d\u00fczensizlikler olu\u015fturur.<\/figcaption><\/figure>\n<p>\u00c7ok ender durumlarda di\u015fler do\u011fru konumlar\u0131n\u0131 korurlar ki; bu durumda \u015fansl\u0131 oldu\u011fu i\u00e7in hastay\u0131 kutlamak gerekir. Uzama veya devrilme basit d\u00fczeyde ise mine seviyesinde m\u00f6lleme, daha ileri d\u00fczeyde ise kron restorasyonu yap\u0131labilir. Ancak \u00e7o\u011funlukla okluzal d\u00fczlem seviyesini d\u00fczenlemek i\u00e7in kron restorasyonundan \u00f6nce kanal tedavisi yap\u0131lmas\u0131 gerekebilir. Daha ileri boyuttaki problemlerde, \u00f6r; kar\u015f\u0131t krete temas edecek kadar uzam\u0131\u015f bir di\u015fin varl\u0131\u011f\u0131nda, periodontal deste\u011fi de azalaca\u011f\u0131ndan, di\u015fin \u00e7ekimi bile d\u00fc\u015f\u00fcn\u00fcl\u00fcr. Bu karar\u0131n, do\u011fru okluzal ili\u015fki elde edilmi\u015f te\u015fhis modellerinde verilmesi en do\u011fru yoldur.<\/p>\n<h2>Sentrik ili\u015fki kayd\u0131<\/h2>\n<p>Sentrik ili\u015fki kayd\u0131nda kullan\u0131lacak y\u00f6ntemin belirlenmesinde di\u015fsizli\u011fin s\u0131n\u0131f\u0131 ve antagonist di\u015f temaslar\u0131 g\u00f6z \u00f6n\u00fcnde tutulur.<\/p>\n<p>Yeterli antagonist di\u015f varl\u0131\u011f\u0131nda, di\u015f destekli vakalarda modeller kar\u015f\u0131l\u0131kl\u0131 getirilir.<\/p>\n<p>Yeterli antagonist di\u015f olmad\u0131\u011f\u0131nda, interokluzal kay\u0131t materyali kullan\u0131larak modeller kar\u015f\u0131l\u0131kl\u0131 getirilir.<\/p>\n<p>Kar\u015f\u0131t \u00e7enede tam protez varl\u0131\u011f\u0131nda, serbest sonlu veya antagonist di\u015f temaslar\u0131n\u0131n olmad\u0131\u011f\u0131 vakalarda ge\u00e7ici kaide pla\u011f\u0131 ve \u015fablon kullan\u0131l\u0131r.<\/p>\n","protected":false},"parent":0,"menu_order":9,"template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"pb_part_invisible":false,"pb_part_invisible_string":""},"contributor":[],"license":[],"class_list":["post-221","part","type-part","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/parts\/221","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/parts"}],"about":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/types\/part"}],"version-history":[{"count":6,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/parts\/221\/revisions"}],"predecessor-version":[{"id":1014,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/parts\/221\/revisions\/1014"}],"wp:attachment":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/media?parent=221"}],"wp:term":[{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/contributor?post=221"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/license?post=221"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}